Journal Alert - JOURNAL OF ATTENTION DISORDERS

Abstract: Objective: This study systematically reviews the current literature on the administration of atomoxetine for treating children and adolescents with comorbidity on autism spectrum disorder (ASD) and ADHD. Method: PubMed/Medline and Google Scholar databases were electronically searched to find the published trials on atomoxetine and ASD. Results: Six articles reported the clinical trials of atomoxetine for treatment of ADHD symptoms in patients with autism or pervasive development disorders. Only one study that was placebo-controlled crossover pilot trial reported that it is effective. Atomoxetine may be effective in high-functioning patients with autism or patients with low severity. Those with high severity of ASD may be more vulnerable to the adverse effects of atomoxetine. Conclusion: There are not enough controlled clinical trials for showing the efficacy of atomoxetine for treatment of ADHD symptoms in autism. Although evidence suggests potential efficacy of atomoxetine, the current evidences are not conclusive.

Abstract: Objective: Longitudinal magnetic resonance imaging (MRI) studies have shown reduced cortical thickness (CT) in individuals with ADHD, but this abnormality disappears with age, suggesting developmental delay. However, cross-sectional MRI studies have shown reduced CT, suggesting abnormal development. The aim of this study was to compare whole-brain CT in male and female children, adolescents, and adults with ADHD with whole-brain CT in matched control participants. Method: MRI scans were performed on ADHD and control participants. Results: CT data revealed differences in right hemisphere (RH) only. Reduced CT was observed predominantly in the frontoparietal region. However, increased CT was observed predominantly in the occipital lobe. The CT differences were correlated with severity of ADHD. Analysis of sex differences revealed that location, number, and magnitude of CT differences were different between males and females in each age group. Conclusion: These data support the hypothesis that anatomical abnormalities in ADHD represent abnormal development rather than developmental delay.

Abstract: Objective: The aim of the study was to assess the functioning of patients with ADHD 6 to 7 years after the diagnosis. One objective was to determine the stability of diagnosis, symptoms decline, subtype change, remission, and change of diagnosis. Method: In all, 101 participants were chosen for testing. All were interviewed for the presence of ADHD and social, academic, and peer functioning, and completed Youth Self-Report. The caregivers completed a Wender Utah Rating Scale and Child Behavior Checklist, and were asked to assess the social, academic, and peer functioning of their offspring. Results: A total of 56% (n = 57) still met the criteria for ADHD and 24.7% (n = 25) still met the criteria for hyperkinetic disorder (HKD). Subtype migration was observed. In all, 7.7% (n = 14) were rediagnosed with Asperger's syndrome, 2.2% (n = 4) received a diagnosis of bipolar disorder, 2.2% (n = 4) were diagnosed with mental retardation, 1 with schizophrenia, and 1 with genetic disorder. Conclusion: The reliability of diagnosis was high. The rates of all subtypes of ADHD decreased. More measures need to be taken in terms of differential diagnosis of ADHD and Asperger's Syndrome.

Title: Prediction of ADHD to Anxiety Disorders: An 11-Year National Insurance Data Analysis in Taiwan

Authors: Tai, YM; Gau, CS; Gau, SSF; Chiu, HW

Source: *JOURNAL OF ATTENTION DISORDERS*, 17 (8):660-669; NOV 2013

Abstract: Objective: To prospectively investigate prediction of ADHD to anxiety disorders (ANXs) in a national sample of Taiwan. Method: From the Taiwan National Health Insurance Dataset (1997-2007), we collected 2,385 cases of new diagnoses of ADHD from 1999 to 2003 and 9,540 sex-, age- and index dates of the first diagnosis of ADHD-matched cohort controls without ADHD. The outcome is age of the first diagnosis of ANXs until December 31, 2007. Results: More cases of ADHD (17.7%) developed ANXs than did matched controls (1.9%) with a younger age onset (12.7 years vs. 17.9 years) and a shorter survival time (1.4 years vs. 5.0 years). Cox models revealed a significant prediction of ADHD to ANXs controlling for other psychiatric comorbidities [Hazard ratio (HR) = 15.83]. The magnitude of such association was greater in males and decreased with older age of first ADHD diagnosis. Conclusion: The findings imply that early detection and treatment for ADHD may offset later development of ANXs.

Title: The Direct Effects of Inattention and Hyperactivity/Impulsivity on Peer Problems and Mediating Roles of Prosocial and Conduct Problem Behaviors in a Community Sample of Children

Authors: Andrade, BF; Tannock, R

Source: *JOURNAL OF ATTENTION DISORDERS*, 17 (8):670-680; NOV 2013

Abstract: Objective: This study tested whether children's symptoms of inattention and hyperactivity/impulsivity were associated with peer problems and whether these associations were mediated by conduct problems and prosocial behaviors. Method: A community sample of 500 children, including 245 boys and 255 girls, who ranged in age from 6 to 9 years (M = 7.6, SD = 0.91) were recruited. Teachers' report of children's inattention, hyperactivity/impulsivity, conduct problems, prosocial behaviors, and peer problems was collected. Results: Symptoms of inattention and hyperactivity/impulsivity were significantly positively associated with peer problems. Conduct problems were associated with more peer problems and prosocial behaviors with less peer problems. Conduct problems and prosocial behaviors partially mediated the association between hyperactivity/impulsivity and peer problems and fully mediated the inattention-peer problems association. Conclusion: Findings show that prosocial behaviors and conduct problems are important variables that account for some of the negative impact of symptoms of inattention and hyperactivity/impulsivity on peer functioning.

Title: Sluggish Cognitive Tempo Among Young Adolescents With ADHD: Relations to Mental Health, Academic, and Social Functioning

Authors: Becker, SP; Langberg, JM

Source: *JOURNAL OF ATTENTION DISORDERS*, 17 (8):681-689; NOV 2013

Abstract: Objective: This study investigated the role of sluggish cognitive tempo (SCT) in relation to externalizing and internalizing mental health problems, academic functioning, and social functioning among young adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: In all, 57 youth ages 10 to 14 participated in the study. Parents rated SCT, internalizing, and externalizing symptoms, as well as social and academic impairment. Teachers rated academic and peer impairment, and intelligence and academic achievement also were assessed. Results: Above and beyond ADHD and conduct problem symptoms, SCT was associated with internalizing mental health symptoms and social problems. The association between SCT and externalizing problems or academic functioning was not significant when accounting for ADHD symptomatology and intelligence. Conclusion: SCT is consistently associated with internalizing symptoms and is also associated with young adolescents' general social difficulties. When controlling for important related constructs, SCT is not associated with externalizing symptoms or academic impairment among young adolescents with ADHD.

Abstract: Objective: The Conners Adult ADHD Rating Scales (CAARS) assess symptoms specific to adults that are frequently used and have been translated into German. The current study tests the factor structure of the CAARS in a large sample of German adults with ADHD and compares the means of the CAARS subscales with those of healthy German controls. Method: CAARS were completed by 466 participants with ADHD and 851 healthy control participants. Confirmatory factor analysis was used to establish model fit with the American original. Comparisons between participants with ADHD and healthy controls and influences of gender, age, and degree of education were analyzed. Results: Confirmatory factor analysis showed a very good fit with the model for the American original. Differences between ADHD participants and healthy controls on all Conners Adult ADHD Rating Scales-Self-Report (CAARS-S) subscales were substantial and significant. Conclusion: The factor structure of the original American model was successfully replicated in this sample of adult German ADHD participants.

Title: Comparison of Mother, Father, and Teacher Reports of ADHD Core Symptoms in a Sample of Child Psychiatric Outpatients

Authors: Sollie, H; Larsson, B; Morch, WT

Source: *JOURNAL OF ATTENTION DISORDERS*, 17 (8):699-710; NOV 2013

Abstract: Objective: To explore the significance of adding father ratings to mother and teacher ratings in the assessment of ADHD symptoms in children. Method: The ADHD Rating Scale-IV, the Child Behavior Checklist, and the Teacher Report Form were filled out by all three informants for a sample of 48 clinically referred children (79% boys) aged 6 to 15 (M = 10.1) years. Results: Correspondence between father and teacher reports on ADHD-specific symptoms (intraclass correlation coefficient [ICC] = .38) exceeded that between mothers and teachers (ICC = .23). Fathers rated their children as having fewer problems than did mothers and teachers on Total scale scores and the Inattention subscale of the ADHD Rating Scale-IV. Mother ratings were more sensitive to an ADHD diagnosis, whereas father ratings better predicted an ADHD diagnosis requiring the two-setting criterion. Conclusion: The choice of parent informant and informant combination had a considerable impact on parent-teacher concordance and estimates of ADHD symptoms and subtypes in the child.

Abstract: Objective: To examine whether cognitive enhancement can be delivered through play to preschoolers with ADHD and whether it would affect severity of ADHD symptoms. Method: Twenty-nine 4- and 5-year-old children and their parents participated in separate group sessions (3-5 children/group). Child groups were introduced games designed to enhance inhibitory control, working memory, attention, visuospatial abilities, planning, and motor skills. Parent groups were encouraged playing these games with their children at least 30 to 45 min/day and taught strategies for scaffolding difficulty levels and dealing with obstacles to daily playing. Results: Parent ratings and session attendance indicated considerable satisfaction with the program. Parent (p < .001) and teacher (p = .003) ratings on the ADHD-Rating Scale-IV (ADHD-RS-IV) indicated significant improvement in ADHD severity from pre- to post-treatment, which persisted 3 months later. Conclusion: This play-based intervention for preschoolers with ADHD is readily implemented at home. Preliminary evidence suggests efficacy beyond the termination of active treatment.

No comments:

About Me

Dr. Kevin McGrew is Director of the Institute for Applied Psychometrics (llc). Additional information, including potential conflicts of interest resulting from commercial test development or other consultation, can be found at The MindHub(TM; http://www.themindhub.com ). General email contact is iap@earthlink.net.